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Type III open tibia fractures in low-resources setting. Part 1: strategy and principles of limb salvage
L Mathieu1, A Grosset2, A Bertani3
1Service de chirurgie orthopédique, traumatologie et chirurgie réparatrice des membres, Hôpital d'instruction des armées Percy, Clamart, France, Chaire de chirurgie appliquée aux armées, École du Val-de-Grâce, Paris, France.
Abstract:
In developing countries, road traffic accidents result in many cases of open trauma, especially fractures, with the tibia area at particular risk in motorcycle crashes. Despite a high prevalence of severe leg trauma with multi-tissue injuries, few studies have focused on the challenge of their reconstruction in these limited-resource settings. The first part of this review presents the surgical strategy. Limitations and principles of initial limb salvage are detailed. Orthopedic procedures for early damage control, based on debridement and temporary bone stabilization, are often required. The priority is to shorten the time to initial surgical management to avoid infection, which jeopardizes reconstruction.
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